In the UK healthcare system, the expense of wound clinical management has grown significantly, placing an increasing burden on patients and the economy. With an annual cost of almost £8.3 billion, the NHS alone managed 3.8 million patients with wounds in 2017–2018. Dressing supplies, wound evaluation and management, and the management of related comorbidities are substantial costs for wound care (Guest et al., 2020).
The high expense of wound care is a result of the complexity of managing chronic wounds, which are more common than ever before, and are mostly brought on by peripheral vascular disorders, pressure ulcers, and diabetes mellitus (Siddiqui & Bernstein, 2010). Every year, pressure ulcers affect over 700,000 people, costing the NHS an estimated £3.8 million daily (Wood et al., 2019).
Patients over 60 are primarily, but not exclusively, affected by chronic wounds (Siddiqui & Bernstein, 2010), and patients must adjust to significant changes in their lifestyle, employment, and self-perception. The patient’s quality of life may be negatively impacted by the uncertainty of the healing process, which could cause guilt, frustration, restlessness, despair, and other negative emotions. In addition, patients deal with chronic pain, which, according to research, has an impact on their day-to-day lives, even when pain is just anticipated rather than experienced physically (Fearns et al., 2017).
Patients may be significantly impacted by health costs, with many of them likely to face financial hardship because of out-of-pocket expenses (Kapp & Santamaria, 2017). As a result, patients’ quality of life is negatively impacted by poor wound healing results, increased morbidity, social isolation, and despair. Thus, it is essential to explore management and prevention strategies for wounds to enhance patient outcomes and quality of life and lessen the financial strain on the healthcare system.
WoundMatrix is a digital-based wound measurement and management system that could be a promising tool for wound care. It provides precise wound measurement, assessment and tracking tools, as well as customised therapy recommendations, using cutting-edge smartphone and tablet technology. The system consists of an app for tracking and measuring wounds in real-time using a cloud-based platform that gives clinicians access to patient analytics and data (WoundMatrix, 2023).
The use of WoundMatrix, and other, similar software, in wound care has the potential to improve wound measuring accuracy, increase treatment planning and monitoring efficiency, enable the delivery of customised therapies depending on patients’ specific needs, and improve delivery of wound care in rural areas (Persistence Market Research, 2022). WoundMatrix has demonstrated the ability to increase wound evaluation accuracy, as it provides precise and reproducible measurements with an acceptable level of variation (Quan et al., 2007).
Kent Community Health NHS Foundation Trust (KCHFT) implemented national recommendations as part of the National Wound Care Strategy Programme (NWCSP). KCHFT are considered a ‘first tranche’ implementation site and were tasked with capturing learnings from the implementation of technological interventions that could improve wound care.
KCHFT collaborated with WoundMatrix Inc. to deploy a telehealth solution which was evaluated to understand the potential staff and patient benefits and estimate the indicative health economic impacts of using WoundMatrix when performing wound assessments within a community care setting.
Unity Insights was commissioned by WoundMatrix and Health Innovation Kent Surrey Sussex (HICKSS), to conduct an evaluation with the aim of assessing the possible impacts of the implementation of the WoundMatrix solution at KCHFT. A mixed methods approach was taken to analyse qualitative, quantitative, and indicative health economic outcomes to generate evidence against the key pre-defined evaluation questions.
A time and motion study, based on patient scenarios, found that replacing paper-based wound assessments with WoundMatrix could potentially result in average staff efficiencies of 7 minutes and 50 seconds per wound assessed. Specifically, the average time savings were greater for existing patients (8 minutes and 32 seconds) than for new patients (5 minutes and 35 seconds).
The majority of this efficiency was realised through reduced paper-based administration.
Broadly, staff highlighted that WoundMatrix is an acceptable and credible platform. Responses to staff surveys indicated that staff felt that WoundMatrix is simple to use, improves clinical safety, wound measurement accuracy, and the efficiency of measuring and documenting wounds (i.e., the photograph function which could allow staff to monitor wound progression and spot deterioration). Some responses indicated that wound assessments may take slightly longer when using WoundMatrix.
The potential net present values for the indicative cost-benefit analysis (CBA) over the financial five-year period (2022/23 – 2026/27) across uptakes and geographies were:
The potential benefit cost ratios (BCR) over the five-year period (2022/23 – 2026/27) were:
A break-even analysis for Scenario 1 demonstrated that a clinical uptake of 35% is required to financially break-even when compared to paper-based forms. Increasing clinician uptake may require additional training and feedback opportunities for clinicians, alongside continued development of WoundMatrix.